By Nancy Melville
Performing sialendoscopy under monitored anaesthesia care demonstrated similar successful outcomes compared with general anaesthesia, with significantly lower time in hospital and recovery, according to a study presented at the 2020 Virtual Meeting of the American Academy of Otolaryngology-Head & Neck Surgery Foundation (AAO-HNSF).
“Our data and experience suggest that while not all sialendoscopy procedure are appropriate for monitored anaesthesia care, it is suitable, safe, and more efficient in the majority of cases,” reported Eric Mastrolonardo, MD, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
The researchers retrospectively reviewed data from adult patients who underwent a sialendoscopy procedure at their medical centre between 2017 and 2019 under general anaesthesia (n = 140) or monitored anaesthesia care (n = 33).
For the primary outcome of the total time in the hospital, the monitored anaesthesia care group had a significant mean reduction of 175.5 minutes (247.0) compared with the general anaesthesia group (422.5 minutes; P< .0001).
Total anaesthesia time was also reduced in the monitored anaesthesia group, with a mean reduction of 48 minutes (P< .0001), as was mean total operation time (reduction of 24.5 minutes), total time in the operating room (45.5-minute reduction), and total recovery time (73-minute reduction; P< .0001 for all).
There was no significant difference in resolution of symptoms between the general anaesthesia and monitored anaesthesia care groups, with 91% and 86% resolution, respectively. In the general anaesthesia group, 4% required further surgical intervention compared with 7% in the monitored anaesthesia care group.
There were no significant differences between groups in the resolution of symptoms, need for further medical management, or need for further surgical intervention.
“Sialendoscopy procedures are unique in that the procedure times are relatively short, so in theory, if multiple procedures are being performed, monitored anaesthesia care could provide the potential to perform more procedures in a given day, potentially increasing hospital revenue,” said Dr. Mastrolonardo.